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→Etiology of kaphaja arsha
भवतश्चात्र-
भवतश्चात्र-
मधुर स्निग्ध शीतानि लवणाम्ल गुरूणि च|
मधुर स्निग्ध शीतानि लवणाम्ल गुरूणि च|
अव्यायामो दिवास्वप्नः शय्यासनसुखे रतिः||१८||
अव्यायामो दिवास्वप्नः शय्यासनसुखे रतिः||१८||
प्राग्वातसेवा शीतौ च देशकालावचिन्तनम्|
प्राग्वातसेवा शीतौ च देशकालावचिन्तनम्|
श्लैष्मिकाणां समुद्दिष्टमेतत् कारणमर्शसाम्||१९||
श्लैष्मिकाणां समुद्दिष्टमेतत् कारणमर्शसाम्||१९||
bhavataścātra-
bhavataścātra-
madhura snigdha śītāni lavaṇāmla gurūṇi ca|
madhura snigdha śītāni lavaṇāmla gurūṇi ca|
avyāyāmo divāsvapnaḥ śayyāsanasukhe ratiḥ||18||
avyāyāmo divāsvapnaḥ śayyāsanasukhe ratiḥ||18||
prāgvātasevā śītau ca deśakālāvacintanam|
prāgvātasevā śītau ca deśakālāvacintanam|
ślaiṣmikāṇāṃ samuddiṣṭametat kāraṇamarśasām||19||
ślaiṣmikāṇāṃ samuddiṣṭametat kāraṇamarśasām||19||
bhavatashcAtra-
bhavatashcAtra-
madhurasnigdhashItAni lavaNAmlagurUNi ca|
madhurasnigdhashItAni lavaNAmlagurUNi ca|
avyAyAmo divAsvapnaH shayyAsanasukhe ratiH||18||
avyAyAmo divAsvapnaH shayyAsanasukhe ratiH||18||
prAgvAtasevA shItau ca deshakAlAvacintanam|
prAgvAtasevA shItau ca deshakAlAvacintanam|
shlaiShmikANAM samuddiShTametat kAraNamarshasAm||19||
shlaiShmikANAM samuddiShTametat kAraNamarshasAm||19||
Etiology and symptoms of dwandaja and sannipataja type of arsha hemorrhoids:
The causes of ''kaphaja arsha'' (hemorrhoids) are as follows:
#Sweet, unctuous, cold, salty, sour and heavy food
#Lack of exercise, sleeping during day time and indulgence in the pleasure of beds and seats (excess sleeping and sitting)
#Direct exposure to wind
#Living in cold place and exposure to cold season and mental inactivity. [18-19]
==== Etiology and symptoms of ''dwandaja'' and ''sannipataja'' type of ''arsha'' hemorrhoids ====
हेतु लक्षण संसर्गाद्विद्याद्द्वन्द्वोल्बणानि च|
हेतु लक्षण संसर्गाद्विद्याद्द्वन्द्वोल्बणानि च|
सर्वो हेतुस्त्रिदोषाणां सहजैर्लक्षणैः समम्||२०||
सर्वो हेतुस्त्रिदोषाणां सहजैर्लक्षणैः समम्||२०||
hetu lakṣaṇa saṃsargādvidyāddvandvolbaṇāni ca|
hetu lakṣaṇa saṃsargādvidyāddvandvolbaṇāni ca|
sarvo hetustridoṣāṇāṃ sahajairlakṣaṇaiḥ samam||20||
sarvo hetustridoṣāṇāṃ sahajairlakṣaṇaiḥ samam||20||
hetulakShaNasaMsargAdvidyAddvandvolbaNAni ca|
hetulakShaNasaMsargAdvidyAddvandvolbaNAni ca|
sarvo hetustridoShANAM sahajairlakShaNaiH samam||20||
sarvo hetustridoShANAM sahajairlakShaNaiH samam||20||
The dwandaja arsha (in which two doshas are predo¬minantly aggravated) is caused by the combination of two types of etiological factors and clinical features of two doshas. If the causative factors of all the doshas are combined together, then tridosaja type of hemorrhoids (in which all the three doshas are simultaneously aggravated) is manifested. The signs and symptoms of hemorrhoids are similar to those described for hereditary type of hemorrhoids- (vide verses 7 and 8 above). [20]
The ''dwandaja arsha'' (in which two ''doshas'' are predominantly aggravated) is caused by the combination of two types of etiological factors and clinical features of two ''doshas''. If the causative factors of all the ''doshas'' are combined together, then ''tridoshaja'' type of hemorrhoids (in which all the three ''doshas'' are simultaneously aggravated) is manifested. The signs and symptoms of hemorrhoids are similar to those described for hereditary type of hemorrhoids (vide verses 7 and 8 above). [20]
==== ''Purvaroopa'' (premonitory) signs and symptoms of hemorrhoids ====
विष्टम्भोऽन्नस्य दौर्बल्यं कुक्षेराटोप एव च|
विष्टम्भोऽन्नस्य दौर्बल्यं कुक्षेराटोप एव च|
कार्श्यमुद्गारबाहुल्यं सक्थिसादोऽल्पविट्कता||२१||
कार्श्यमुद्गारबाहुल्यं सक्थिसादोऽल्पविट्कता||२१||
ग्रहणीदोषपाण्ड्वर्तेराशङ्का चोदरस्य च|
ग्रहणीदोषपाण्ड्वर्तेराशङ्का चोदरस्य च|
पूर्वरूपाणि निर्दिष्टान्यर्शसामभिवृद्धये||२२||
पूर्वरूपाणि निर्दिष्टान्यर्शसामभिवृद्धये||२२||
viṣṭambho’nnasya daurbalyaṃ kukṣerāṭopa eva ca|
viṣṭambho’nnasya daurbalyaṃ kukṣerāṭopa eva ca|
kārśyamudgārabāhulyaṃ sakthisādo’lpaviṭkatā||21||
kārśyamudgārabāhulyaṃ sakthisādo’lpaviṭkatā||21||
grahaṇīdoṣapāṇḍvarterāśaṅkā codarasya ca|
grahaṇīdoṣapāṇḍvarterāśaṅkā codarasya ca|
pūrvarūpāṇi nirdiṣṭānyarśasāmabhivṛddhaye||22||
pūrvarūpāṇi nirdiṣṭānyarśasāmabhivṛddhaye||22||
viShTambho~annasya daurbalyaM kukSherATopa eva ca|
viShTambho~annasya daurbalyaM kukSherATopa eva ca|
kArshyamudgArabAhulyaM sakthisAdo~alpaviTkatA||21||
kArshyamudgArabAhulyaM sakthisAdo~alpaviTkatA||21||
grahaNIdoShapANDvarterAsha~gkA codarasya ca|
grahaNIdoShapANDvarterAsha~gkA codarasya ca|
pUrvarUpANi nirdiShTAnyarshasAmabhivRuddhaye||22||
pUrvarUpANi nirdiShTAnyarshasAmabhivRuddhaye||22||
Delayed digestion of the food, weak¬ness, gurgling sound in the lower abdomen, emaciation, fre¬quent eructation; pain in thighs, voiding less stool, anemia, apprehension of the manifestation of udararoga (obstinate abdominal disorders including ascites)-these are the premonitory signs and symptoms in the development of hemorrhoids. [21-22]
Delayed digestion of the food, weakness, gurgling sound in the lower abdomen, emaciation, frequent eructation; pain in thighs, voiding less stool, anemia, apprehension of the manifestation of ''udararoga'' (obstinate abdominal disorders including ascites)-these are the premonitory signs and symptoms in the development of hemorrhoids. [21-22]
Involvement of three doshas:
==== Involvement of three ''doshas'' ====
अर्शांसि खलु जायन्ते नासन्निपतितैस्त्रिभिः|
अर्शांसि खलु जायन्ते नासन्निपतितैस्त्रिभिः|
दोषैर्दोषविशेषात्तु विशेषः कल्प्यतेऽर्शसाम्||२३||
दोषैर्दोषविशेषात्तु विशेषः कल्प्यतेऽर्शसाम्||२३||
Hemorrhoids never manifest without the aggravation of all the three doshas. It is evident that the predominance of one or all the doshas determine the type of hemorrhoids. The nomenclature of doshaja arsha is given according to the predominance of dosha e.g. if vata dosha is predominat then that hemorrhoid is said to be vataja arsha. [23]
Hemorrhoids never manifest without the aggravation of all the three doshas. It is evident that the predominance of one or all the doshas determine the type of hemorrhoids. The nomenclature of doshaja arsha is given according to the predominance of dosha e.g. if vata dosha is predominat then that hemorrhoid is said to be vataja arsha. [23]
Aggravation of tridosha in arsha:
==== Aggravation of tridosha in arsha ====
पञ्चात्मा मारुतः पित्तं कफो गुदवलित्रयम्|
पञ्चात्मा मारुतः पित्तं कफो गुदवलित्रयम्|
सर्व एव प्रकुप्यन्ति गुदजानां समुद्भवे||२४||
सर्व एव प्रकुप्यन्ति गुदजानां समुद्भवे||२४||